A nurse is developing a discharge plan for a client who is postoperative and will require a wheelchair in the home. The nurse should place a referral to which of the following resources to assist the client with this need?

Occupational therapy

Social services

Home health

Physical therapy

Answer and Explanation

The Correct Answer is B

a. Occupational therapy: Occupational therapists focus on helping clients develop, recover, or maintain daily living and work skills. They can assist with adapting the home environment for safety and independence but do not typically arrange for durable medical equipment like wheelchairs.

b. Social services: Correct. Social services can help coordinate the provision of durable medical equipment such as wheelchairs. They can assist with arranging the delivery of the equipment, addressing insurance or financial concerns, and connecting the client with community resources and support services.

c. Home health: Home health services can provide ongoing medical care and assistance at home, but they do not typically handle the logistics of securing durable medical equipment like wheelchairs. They might recommend or facilitate a referral to social services for this need.

d. Physical therapy: Physical therapists help clients regain strength and mobility and may train clients on how to use a wheelchair effectively, but they do not typically arrange for the provision of the wheelchair itself.

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Correct Answer is B

Explanation

a. Administer a sedative to the client:

Administering a sedative may temporarily calm the client, but it should not be the first-line intervention, especially without a physician's order. Sedatives carry risks and should only be used when other interventions have been considered and deemed ineffective or when the client's behavior poses an immediate danger to themselves or others.

b. Contact a family member to come and sit with the client: could indeed be a valid first step. If a family member is available and able to assist, they could potentially calm the client without the need for isolation and reducing disruptive behavior.However, if this is not feasible, then ensuring the client’s safety through temporary isolation with frequent checks might be necessary.

c. Place the client in a wheelchair with a lap tray:

Placing the client in a wheelchair with a lap tray may restrict their movement and potentially exacerbate agitation or aggression. It does not address the underlying reasons for the behavior and may not be an appropriate intervention for managing wandering behavior.

d. Keep the client in her room with the door closed:

Isolating a client in their room could be considered a form of restraint or isolation and should be used with caution.This should be used only after other less restrictive measures have been tried and deemed ineffective.

A. Continue the medication dosages that relieve the client’s pain B. Contact the provider about replacing the opioid with an NSAID C. Administer the benzodiazepine but withhold the opioid D. Withhold the benzodiazepine but continue the opioid

Correct Answer is A

Explanation

A. Continue the medication dosages that relieve the client’s pain:
Opioids and benzodiazepines are commonly used for pain and anxiety management in terminally ill patients. Somnolence is an expected side effect and does not necessarily warrant withholding medication unless the client shows signs of respiratory depression.

B. Contact the provider about replacing the opioid with an NSAID: NSAIDs are not sufficient for severe pain in terminal illness. Opioids are the gold standard for palliative pain management, and switching to an NSAID would likely lead to uncontrolled pain and unnecessary suffering.

C. Administer the benzodiazepine but withhold the opioid: This would leave the client in severe pain, which is unethical in hospice care. Pain relief should not be withheld solely due to sedation.

D. Withhold the benzodiazepine but continue the opioid: Benzodiazepines are often used to relieve anxiety, dyspnea, and agitation in end-of-life care. Withholding it could cause increased distress for the client. Instead of discontinuing the medication, the nurse should monitor for respiratory depression and adjust doses only if necessary.

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A nurse is developing a discharge plan for a client who is postoperative and will require a wheelchair in the home. The nurse should place a referral to which of the following resources to assist the client with this need?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who wanders through the halls yelling obscenities at staff, other clients, and visitors. Which of the following action should the nurse take?

Correct Answer is B

Explanation

A hospice nurse is caring for a client who has a terminal illness and reports severe pain. After the nurse administers the prescribed opioid and benzodiazepine, the client becomes somnolent and difficult to arouse. Which of the following actions should the nurse take?

Correct Answer is A

Explanation

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